Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
PLoS One. 2024 Apr 18;19(4):e0298952. doi: 10.1371/journal.pone.0298952. eCollection 2024.
Our understanding of the specific aspects of vascular contributions to dementia remains unclear.
We aim to identify the correlates of incident dementia in a multi-ethnic cardiovascular cohort.
A total of 6806 participants with follow-up data for incident dementia were included. Probable dementia diagnoses were identified using hospitalization discharge diagnoses according to the International Classification of Diseases Codes (ICD). We used Random Forest analyses to identify the correlates of incident dementia and cognitive function from among 198 variables collected at the baseline MESA exam entailing demographic risk factors, medical history, anthropometry, lab biomarkers, electrocardiograms, cardiovascular magnetic resonance imaging, carotid ultrasonography, coronary artery calcium and liver fat content. Death and stroke were considered competing events.
Over 14 years of follow-up, 326 dementia events were identified. Beyond age, the top correlates of dementia included coronary artery calcification, high sensitivity troponin, common carotid artery intima to media thickness, NT-proBNP, physical activity, pulse pressure, tumor necrosis factor-α, history of cancer, and liver to spleen attenuation ratio from computed tomography. Correlates of cognitive function included income and physical activity, body size, serum glucose, glomerular filtration rate, measures of carotid artery stiffness, alcohol use, and inflammation indexed as IL-2 and TNF soluble receptors and plasmin-antiplasmin complex.
In a deeply phenotyped cardiovascular cohort we identified the key correlates of dementia beyond age as subclinical atherosclerosis and myocyte damage, vascular function, inflammation, physical activity, hepatic steatosis, and history of cancer.
我们对血管因素导致痴呆的具体方面的了解仍不清楚。
我们旨在确定一个多民族心血管队列中发生痴呆的相关因素。
共纳入 6806 名有新发痴呆随访数据的参与者。根据国际疾病分类代码（ICD），通过住院诊断来确定可能的痴呆诊断。我们使用随机森林分析，从基线 MESA 检查中收集的 198 个变量中识别出与新发痴呆和认知功能相关的因素，这些变量包括人口统计学风险因素、病史、人体测量学、实验室生物标志物、心电图、心血管磁共振成像、颈动脉超声、冠状动脉钙和肝脂肪含量。死亡和中风被视为竞争事件。
在 14 年的随访期间，共发现 326 例痴呆事件。除年龄外，痴呆的主要相关因素包括冠状动脉钙化、高敏肌钙蛋白、颈总动脉内膜中层厚度、NT-proBNP、体力活动、脉压、肿瘤坏死因子-α、癌症史和计算机断层扫描的肝脾衰减比。认知功能的相关因素包括收入和体力活动、身体大小、血清葡萄糖、肾小球滤过率、颈动脉僵硬度测量、饮酒以及炎症指标 IL-2 和 TNF 可溶性受体以及纤溶酶-抗纤溶酶复合物。
在一个深入表型的心血管队列中，我们确定了除年龄以外的痴呆的关键相关因素，包括亚临床动脉粥样硬化和心肌损伤、血管功能、炎症、体力活动、肝脂肪变性和癌症史。
